Autoimunidade e vitamina D : um estudo em portadores de artrite reumatoide e espondilite anquilosante

Abstract

Introduction: In recent years, there has been an increasing prevalence of autoimmune diseases. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are diseases that alter the patient's life in different degrees of physical, social, economic and/or psychological disability depending on their severity and cause important functional limitations. Some studies show an important immunomodulatory effect of vitamin D and its relationship with autoimmune diseases. Objective: To evaluate the biochemical profile and the relationship with vitamin D levels in patients with RA and AS. Methods: Retrospective clinical cross-sectional study, developed in the city of Cuiabá - MT, with 176 patients over 20 - 85 years old, diagnosed with RA and AS, from the Júlio Muller University Hospital, from the rheumatology Outpatient Clinic. Data from medical records (demographic, biochemical and nutritional status) were analyzed. The results were obtained by descriptive analysis, central tendency, dispersion and inferential analysis using SPSS software version 20.0. The sex, autoimmune and vitamin D concentration groups were compared. The tests performed were Kolmogorov-Smirnov n > 30 and Shapiro-Wilk n < 30, at 5 %; For comparisons between groups, the Wilcoxon-Mann-Whitney-U test was applied. The Spearman/Pearson correlation was used to track the association between concentrations of vitamin D levels and other variables studied. In the hypothesis tests, significance OHYHOVS ZHUHFRQVLGHUHG 0DWKHPDWLFDOPRGHOLQJIRUSUHGLFWLQJ vitamin D levels was obtained as a function of the variables CT, TG and sex. Results: The sample had a greater number of female patients, both for RA (86.1%) and for AE (64.2%). The mean age of the AR group was significantly higher than that of the EA group (11 years older). Regarding the analysis of biochemical tests, there was a significant difference in the averages of CRP (p=0.012) and ESR (p=0.011) between the AR and AS groups. For the other exams, there was no significant difference. Significantly higher levels of TC were observed for the group of patients with insufficient levels of vitamin D (202.76 ± 46.16; p=0.001), with a negative correlation between vitamin D levels and TC (p<0, 01). Three mathematical models were obtained, which explained the variations in vitamin D (Model 1: DV = 42.976 - 0.60 TC; p<0.05; Model 2: DV= 49.189 - 0.109 TC + 0.046 TG; p<0.05 ; Model 3: DV= 42.125 - 0.055 CT; p<0.05) Conclusion: The study shows a higher prevalence of autoimmune diseases in women, and earlier manifestation of AS than RA in patients. The inverse correlation between cholesterol and vitamin D levels is still poorly studied, but due to the high risk of developing other chronic diseases, it raises the need for further studies that may contribute in some way to improving the quality of life of these patients.